Stuart Andrew: The Government have taken steps to modernise the application process for obtaining a gender recognition certificate and to make applications more affordable. GRC applicants are now required to pay £5 and the newly developed digital application process for GRCs launched on 29 June.

[Relevant documents: Second report of the Levelling Up, Housing and Communities Committee, Long-term funding of adult social care, HC 19; first joint report of the Health and Social Care Committee and the Housing, Communities and Local Government Committee of Session 2017–2019, Long-term funding of adult social care, HC 768; correspondence from the Chair of the Levelling Up, Housing and Communities Committee to the Secretary of State, on the Government’s response to the Committee’s report on the Long-term funding of adult social care, reported to the House on 20 February 2023; and correspondence from the Minister for Local Government and Building Safety, on the Government response to the Committee’s report on long-term funding of adult social care, reported to the House on 7 March 2023.]
Motion made, and Question proposed,
That, for the year ending with 31 March 2023, for expenditure by the Department for Levelling Up, Housing and Communities:
(1) the resources authorised for current purposes be reduced by £2,074,000 as set out in HC 1133,
(2) the resources authorised for capital purposes be reduced by £2,428,760,000 as so set out, and
(3) the sum authorised for issue out of the Consolidated Fund be reduced by £4,454,598,000.—(Lee Rowley.)

Clive Betts: I thank everyone concerned for the opportunity to lead this debate on behalf of the Levelling Up, Housing and Communities Committee. Adult social care is an important issue, which the Committee has come back to on several occasions.
Last year, we produced another report on long-term funding for adult social care. We were happy to receive letters, in the last couple of days, from the Under-Secretary of State for Levelling Up, Housing and Communities, the hon. Member for North East Derbyshire (Lee Rowley), and the Minister for Health and Secondary Care, the hon. Member for Colchester (Will Quince), both saying why they have not yet responded to the report that was produced around nine months ago.
As you know, Mr Speaker, the advice is that Government should respond to Select Committee reports within eight weeks, so eight months seems rather a long time. I know that there have been quite a few changes of Minister during that period, so perhaps that explains some of the delay. If this was just a one-off, it would probably be excusable, but the Select Committee rarely gets a response within months, let alone weeks, of a report being produced, which is a little frustrating when we have put so much effort into them. We have not even had a proper response to the joint report that we produced with the Health and Social Care Committee back in June 2018—almost five years ago, which must  get near a record for non-responses to Select Committee reports. The Health and Social Care Committee has also done its own reports into these matters, as have many reputable organisations, such as The King’s Fund.
Given the nature of the debate, I will concentrate on the impact on local government funding. Although social care, as a responsibility, lies with the Department of Health and Social Care, it is ultimately delivered through funding from local councils. I want to concentrate on the challenge that that poses for councils. This is not a new matter and is not without a lot of commitments. Only last year, the right hon. Member for South West Norfolk (Elizabeth Truss) said that she would spend £13 billion raised by the levy on social care. Well, the levy seems to have disappeared into other uses, as has the £13 billion.
The right hon. Member for Uxbridge and South Ruislip (Boris Johnson) said:
“I am announcing now—on the steps of Downing Street—that we will fix the crisis in social care once and for all”.
Not to be outdone, the right hon. Member for Maidenhead (Mrs May) said that her Ministers
“will work to improve social care and will bring forward proposals for consultation.”—[Official Report, 21 June 2017; Vol. 626, c. 35.]
Let us go back a bit further. David Cameron said:
“A commission will be appointed to consider a sustainable long-term structure for the operation of social care.”—[Official Report, 25 May 2010; Vol. 510, c. 31.]
I will not just be party political in this, because Gordon Brown said:
“Alan Johnson and I will…bring…new plans to help people to stay longer in their own homes and provide greater protection against the costs of care.”
The one thing that Prime Ministers have in common over the years is that they all promise to deal with the problems and funding of social care. The other thing that they have in common is that none of them has actually done that, and that is something of concern and it is why we still have the problems today.
Let me put this in the context of local government funding. Local government has had the biggest cuts of any part of the public sector since 2010. The National Audit Office and the Library have produced some interesting figures, which are known to be authoritative. They have said that the cut in core spending power for councils in the decade after 2010 has been 26%. By comparison, the increase in funding for the Department of Health and Social Care has been 14%. So that is 26% down for local government and 14% up for the Department of Health and Social Care. I am not begrudging the extra spending on health, but, clearly, councils also do important work and that is not really reflected in the figures.
The reason for that cut in spending power is that the revenue support grant has fallen by 37% over that similar period. A 25% increase in council tax has helped cover some of that fall. Council tax spending as a percentage of total local government spend—the percentage funded by council tax—has gone up from 41% of local government spend to 60%. In other words, council tax has been going up as the Government grant has fallen, but the totality of spending has fallen as well.
Councils’ spending on social care—social care as a whole, including children’s care—has risen by 8.9% in real terms, but non-care spending by authorities has  fallen by 32%. That is the knock-on effect—we must keep reminding ourselves of the consequences of this. Social care spending has now roughly risen from 50% of council spending to 60% over the period. Those are very dramatic changes in how councils spend their money.
Let us look at services such as planning. I know that they are important for the future of our country, for future growth and for regeneration. Spending by councils on planning has fallen by about 50%. That is a staggering fall. There have been similar falls in regeneration and economic development, which will be important for the levelling up agenda.
Let us look now at libraries, buses and street cleaning, which are important services that everyone tends to use in some way. They have all fallen by between 30% and 50%. The real challenge for local democracy—the Minister on the Front Bench has responsibility for local government—is that people are now finding that their council tax is going up by amounts that I have just described, but, if they or their immediate relatives do not use social care, they are seeing all the services that they receive fall. That is a fundamental challenge for local democracy—people pay more and get less. That is not defensible in the medium term, but it has been going on for 10 years now, and something has to give.
We might think, “Well, it’s alright as long as social care is sorted out,” but it is not, is it? Let us just look at the particular problems with social care and social care funding. Before the autumn statement last year, the Local Government Association said that it thought that about £7 billion was the shortfall currently. I appreciate that the Minister will no doubt advise us of all the goodies that were delivered in the settlement for the next financial year, and, clearly, there were some helpful increases of money, but not the £7 billion that local councils were looking for. The problem is that that settlement contains some of the elements of the problems that we have been experiencing for a decade or longer now. First, so much of the funding councils get is short-term. Yes, the better care grants and the social care grants are welcome, but much of it is on a one-off basis. Much of last time’s settlement was on a one-off basis, with the extra money coming in those forms of grants, together with the increases in council tax I mentioned previously.
We know there are two fundamental problems with increases in council tax: first, they raise far more money in the most affluent communities than in the poorest communities, and secondly, they are regressive—not my word, but the Secretary of State’s. I know the Minister has been charged with finding a solution to that problem. Good luck to him—we look forward to his report in due course, and we had an interesting dialogue with him in the Select Committee the other week. We are asking more from people on low incomes with proportionately lower house values, and giving less to the poorest communities through the increases. That is not the best way to fund social care in the longer term.
We know that, although funding has been going up, demand is rising. There are more unhealthy people in our communities, as we all know; we can see the figures for ourselves. Often forgotten, however, is the rising demand from people with disabilities. People with a whole variety of disabilities, both learning and physical, are living longer. Where they might have died in their 30s, they are now very often living into their 50s, to the  point where parents who once looked after them can no longer help or support them. Those parents are worried sick about what will happen to their children when they no longer have that parental support available. That demand must also be met and recognised.

Helen Morgan: It is lovely to see you back in the Chair, Madam Deputy Speaker. I thank the hon. Member for Sheffield South East  (Mr Betts) and the right hon. Member for Ashford (Damian Green) for their excellent speeches. I draw the House’s attention to the fact that I am a vice-president of the Local Government Association.
When the Government announced their local government funding settlement for the upcoming year and the additional £2.3 billion in grant funding at the autumn statement designated for social care, I welcomed that additional funding, despite concerns that much of the rest of the money will come from increased council tax. We are passing the buck from Government to local councils and, ultimately, as the hon. Member for Sheffield South East outlined eloquently, to local taxpayers who may not immediately see the benefit of the tax they are paying.
That funding will plug in the short term the gap in budgets caused by inflationary pressure, but we need to be mindful that 542,000 people are already waiting for care package assessments or direct payments and there are thousands of vacancies in England, according to the Association of Directors of Adult Social Services. The County Councils Network warns that councils and care providers are facing a perfect storm, as I am sure we are all aware, of rising demand, fewer care home beds, chronic staff shortages and acute inflationary pressures.
Shropshire is certainly no exception to that scenario. My meetings with local care providers have consistently shown that the sector is becoming fundamentally unstable, with some providers left facing a choice between losing money, or handing their contracts back to the council and restricting themselves to private work. We should acknowledge that social care is becoming a two-tier sector, where people who can afford a large amount of care in their home every day receive a very good service from skilled and caring workers who come and attend them, but those who are left with only a short visit in their own home see a much worse situation. I have seen that first-hand on an ambulance shift. It is heartbreaking to see people whose carers have popped in on a rushed schedule. They clearly care and have written everything down in the book—in one case, they had called the ambulance—but they do not have time to ensure that those individuals are living in the dignity they deserve. We need to ensure that that variation and those dual standards are addressed in the solutions we propose.
We have also seen that a shortage of care options is a factor in the acute emergency department and ambulance response crisis that Shropshire has faced, because people who are unable to be discharged home are restricting the patient flow through hospitals and ultimately stopping people coming in through the front door.
Today, I would like to raise in particular the challenges faced in the long-term learning disability and autism sector. In this sector, where people with learning disabilities need long-term care, the providers often do not have private clients from whom they can cross-subsidise their council-funded packages. My attention was drawn to that just before Christmas when I was alerted to the fact that three individuals in my consistency, who have lived in a care home together and been cared for by the same care home manager for more than 20 years, faced being split up and rehomed just three weeks before Christmas. Worse than that, because their levels of need were high and the care in North Shropshire met this need, they had come from across the United Kingdom and were  funded by different councils. If their care home closes because of cost pressure, they will most likely be split from each other. As I am sure we can all imagine, the impact on those individuals would be extremely severe. I was grateful in this case that their provider was able to reassess their situation and keep them together in the same location, but the funding in this sector is so precarious that there is no guarantee that will be maintained.
As I understand it, the fair cost of care exercise excluded many social care services for people with learning disabilities, autism or severe mental health problems. In learning disability and autism services, a recent survey showed that 71% of providers have handed back a contract, declined to deliver a service or considered doing so in the past 12 months. Some 83% are subsidising services as charitable organisations that should be paid for in full by the state. We can all recognise that is fundamentally unsustainable, and I urge the Minister to consider some of the excellent suggestions from colleagues to stabilise this growing sector caring for our most vulnerable people.
Part of the cause of the instability across the whole sector is the fact that rising minimum wage levels have not been matched by funding from central Government to local councils, and therefore from those councils on to the providers. The national living wage increased by 6.6% from 1 April 2022, and it will go up by a further 9.7% from 1 April 2023. Clearly, that is necessary to deal with the cost of living crisis, and I am not here to begrudge care workers that increase. The staff in the sector are providing caring, highly skilled support, and they deserve to be recognised with a fair pay packet for the work they do.
In rural parts of Britain, such as North Shropshire, home care and community-based services are also seeing pressure from high fuel costs, and the council funding they receive does not take into account either the additional fuel they use travelling around such a large area, or the additional dead time there is between visits to people in rural places. In October 2022, Shropshire Partners in Care, an organisation of care providers in Shropshire, conducted a survey of its members, in which only 18% of respondents said that they felt the fees provided by the council covered their costs on a weekly basis. More than half confirmed that they have reduced the number of council-funded packages or places they are willing to accept.
When I meet care providers in my constituency and carers at work when I am on the doorstep, I am struck by their passion for providing high-quality care for their clients, but I have also been struck by the distress that the cost and recruitment pressures are placing on providers, because they are affecting the quality of service they deliver. The problem is nationwide, too. A Liberal Democrat councillor and friend in Cambridgeshire told me they are seeing an urgent crisis in adult social care there, too. They are facing an estimated 40% projected rise in funding for the elderly, but they have not got the Government funding to match, so they are looking at a £23 million funding gap going forward. They have nursing homes with 50% vacancy rates at peak points during the winter.
I urge the Minister to commit to looking at the long-term settlement for councils, because these costs, as colleagues have already described in great detail, will only increase. We need to ensure that we are fully funding the cost increases for care providers, so that  people can receive the care they need and deserve, whether in a care home or, ideally, in their own home. The settlement also needs to take rurality into account and reflect the additional costs incurred when carers are travelling such long distances between homes. It is critical that councils have the flexibility to spend the funding they have been allocated in the most appropriate way for their own area and the requirements of their local demographic.
The Minister will be aware that the Liberal Democrats have called for a fully funded carers minimum wage set at least £2 above the national average, and paid for by a tax on online gambling platforms, to address the recruitment and retention challenges that are knocking into other areas of social and NHS care. Our increased wage would be centrally funded and it would ease the pressures on councils to find savings from elsewhere to meet their social care needs. The Care Quality Commission’s 2022 state of care report stated that
“our health and care system is in gridlock and this is clearly having a huge negative impact on people’s experiences of care.”
It went on to say:
“At the heart of these problems are staff shortages and struggles to recruit and retain staff right across health and care.”
I urge the Minister to consider the points that we have raised, to consider the crucial nature of ensuring that care workers are paid fairly so that they can be recruited and retained, and to consider that whatever the plan is going forwards, it needs to ensure that councils have certainty about their future funding. I urge him to take note of the pressures and to work with his Treasury colleagues to address some of the huge challenges that we have outlined today.

[Relevant documents: Fourth report of the Work and Pensions Committee, Universal Credit and childcare costs, HC 127; first report of the Petitions Committee of Session 2021–22, Impact of Covid-19 on new parents: one year on, HC 479, and the Government response, HC 1132; first report of the Petitions Committee of Session 2019–21, The impact of Covid-19 on maternity and parental leave, HC 526, and the Government response, HC 770; oral evidence taken before the Education Committee on 31 January and 21 February 2023, on Support for Childcare and the Early Years, HC 969; correspondence from the Work and Pensions Committee to the Secretary of State for Work and Pensions, on Universal Credit and childcare costs Report, reported to the House on 22 February 2023; e-petition 624461, Fund 30 hours free childcare from age 1 for families where both parents work; e-petition 586700, Commission an independent review of childcare funding and affordability; e-petition 615623, Do not reduce staff-child ratios in early years childcare; e-petition 628412, Increase funding for early years settings; e-petition 580137, Offer 15hrs free childcare for multiples under 3 years.]
Motion made, and Question proposed,
That, for the year ending with 31 March 2023, for expenditure by the Department for Education:
(1) further resources, not exceeding £3,096,686,000, be authorised for use for current purposes as set out in HC 1133,
(2) the resources authorised for capital purposes be reduced by £1,580,042,000 as so set out, and
(3) a further sum, not exceeding £145,625,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Claire Coutinho.)

Resolved,
That, for the year ending with 31 March 2023, for expenditure by the Department for Levelling Up, Housing and Communities:
(1) the resources authorised for current purposes be reduced by £2,074,000 as set out in HC 1133,
(2) the resources authorised for capital purposes be reduced by £2,428,760,000 as so set out, and
(3) the sum authorised for issue out of the Consolidated Fund be reduced by £4,454,598,000.

Resolved,
That, for the year ending with 31 March 2023, for expenditure by the Department for Education:
(1) further resources, not exceeding £3,096,686,000, be authorised for use for current purposes as set out in HC 1133,
(2) the resources authorised for capital purposes be reduced by £1,580,042,000 as so set out, and
(3) a further sum, not exceeding £145,625,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.
The Deputy Speaker then put the Question on the outstanding Estimates (Standing Order No. 55).

Resolved,
That, during the year ending with 31 March 2024, a number not exceeding 39,550 all ranks be maintained for Naval and Marine Service and that numbers in the Reserve Naval and Marines Forces be authorised for the purposes of Parts 1, 3, 4, and 5 of the Reserve Forces Act 1996 up to the maximum numbers set out in Votes A 2023–24, HC 1036.

Resolved,
That, during the year ending with 31 March 2024, a number not exceeding 102,250 all ranks be maintained for Army Service and that numbers in the Reserve Land Forces be authorised for the purposes of Parts 1, 3, 4 and 5 of the Reserve Forces Act 1996 up to the maximum numbers set out in Votes A 2023–24, HC 1036.

Resolved,
That, during the year ending with 31 March 2024, a number not exceeding 36,500 all ranks be maintained for Air Force Service and that numbers in the Reserve Air Forces be authorised for the purposes of Parts 1, 3, 4 and 5 of the Reserve Forces Act 1996 up to the maximum numbers set out in Votes A 2023–24, HC 1036.

[Relevant document: Thirty-ninth report of the Committee of Public Accounts, Excess Votes 2021–22, HC 1132.]
Resolved,
That, for the year ending with 31 March 2022, resources, not exceeding £2,457,088,000, be authorised to make good excesses for use for current purposes as set out in the Statement of Excesses 2021–22, HC 1135.

Resolved,
That, for the year ending with 31 March 2023:
(1) further resources, not exceeding £7,756,204,000, be authorised for use for current purposes as set out in HC 1105, HC 1112, HC 1133 and HC 1145,
(2) the resources authorised for capital purposes be reduced by £8,829,421,000 as so set out, and
(3) the sums authorised for issue out of the Consolidated Fund be reduced by £20,188,514,000.

Resolved,
That, for the year ending with 31 March 2024:
(1) resources, not exceeding £370,588,547,000 be authorised, on account, for use for current purposes as set out in HC 1090, HC 1106, HC 1111, HC 1134, HC 1146, HC 1167 and HC 1172,
(2) resources, not exceeding £93,152,800,000, be authorised, on account, for use for capital purposes as so set out, and
(3) a sum, not exceeding £374,553,971,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund, on account, and applied for expenditure on the use of resources authorised by Parliament.—(Fay Jones.)
Ordered, That a Bill be brought in upon the foregoing Resolutions relating to Supplementary Estimates 2022-23, Excesses 2021-22 and Vote on Account 2023-24;
That the Chairman of Ways and Means, the Chancellor of the Exchequer, John Glen, Victoria Atkins, Andrew Griffith and James Cartlidge, bring in the Bill.

Presentation and First Reading
Victoria Atkins accordingly presented a Bill to authorise the use of resources for the years ending with 31 March 2022, 31 March 2023 and 31 March 2024; to authorise the issue of sums out of the Consolidated Fund for  those years; and to appropriate the supply authorised by this Act for the years ending with 31 March 2022 and 31 March 2023.
Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 266) with explanatory notes (Bill 266-EN).